1. Genetics - Women > Men
2. Shoe wear – high heels, tight or uncomfortable shoe wear, poor arch support
3. Mechanics – flat foot, intoe in children

1. Conservative – Appropriate shoe gear to accommodate foot deformity, custom molded orthotics – physician and patient specific, injections and physical therapy in cases of acute inflammation.
2. Surgical management – appropriate when conservative treatment has failed, in cases where foot deformity changes quality of life.

Benign enlargement of a nerve usually in the area of 3,4th digit

Usually inappropriate shoe wear
Deviation of biomechanics in the foot

Conservative – physical therapy, modification in shoe gear, injections, orthotics Surgical – excision

Moderate to severe heel pain often with inability to ambulate
Most painful in the morning and pain gets better during the day
Self-limited although no time frame1week vs 1 year

Shortening of the plantar fascial ligament causes pulling on the bone at that ligament insertion into the bone creating a heel spur on the bottom of the foot

Conservative – stretching exercises, rest, ice, elevate, injections, orthotics Surgical - very rare, endoscopic procedure to cut part of the ligament to stretch it

Similar conditions site dependent – treatment depends on the site, level of patient’s activity, mostly physical therapy, strappings, exercises

Has reached epidemiological scale in the United States
Affects every single organ in the human body
More than in any disease multifactorial approach needed toward the patient
Vascular specialist, Nephrologist, Ophthalmologist, Nutritionist, Podiatrist
Up to Primary care physician to direct proper care
Up to the patient to control blood sugar, Exercise, Observe proper diet
Podiatry follow up is of outermost importance
Podiatrist a major educator in a diabetic care